| NPI | 1245702794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024188262) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN60900007) |
| 363LF0000X Nurse Practitioner Family (Licence: WA AP61186590) | |
| Enumeration Date | 2018-12-21 |
| Last Update Date | 2024-01-31 |